On a farm in the heart of Hawaii's ongoing dengue outbreak, coffee grows wild among the ferns, and vanilla vines climb guava trees. It's hard to know where nature ends and the farm begins, and that's the way organic farmers there like it.
But state efforts to combat the outbreak — and prevent the related
Global health officials have identified mosquito eradication as the key to curtailing the Zika outbreak that has taken hold in Latin America and been linked to birth defects in Brazil, as well as preventing it from taking hold in other areas where the Aedes aegypti mosquito is prevalent, including the southern U.S.
"Any place a dengue outbreak can occur, a Zika outbreak could occur," Lyle Peterson, director of the
is always the possibility of infecting local mosquitoes."
But mosquito control is highly variable around the U.S., and a chunk of the $1.8 billion in emergency funding the Obama administration is seeking for Zika would go to shoring up those capabilities, Dr. Anne Schuchat, the CDC's principle deputy director, told a Senate committee this month.
"In many areas, there are big holes," she said.
Plus, this mosquito species is an aggressive daytime biter that can live not just in the yard but inside the house. A little water left in a flower pot is enough for its eggs to hatch; they even can survive drought until rain returns.
Hawaii has had four cases of Zika, all in travelers to countries with ongoing transmission, according to the CDC. But local mosquitoes have infected 260 people on the Big Island with dengue fever. And the CDC reported active local Zika transmissions in Pacific islands that have a fair amount of traffic to Hawaii, including Samoa, American Samoa, the Marshall Islands and Tonga.
In a report, Peterson said staff shortages in the state Health Department and conditions on the island make it difficult to fight mosquito-borne diseases. The report cited abundant mosquito breeding grounds, dense vegetation, unoccupied homes and widespread use of cisterns to provide water to households.
On Old Ways Farm, organic farmer Steve Mann tends to his herbs with mosquito netting dangling from his straw hat.
He wouldn't allow his home or farm to be sprayed with pesticides. "It's not organic, and that would cancel our certification for a period of three years," Mann said. "That might well put us out of business."
Organic farmers aren't the only ones pushing back. Hundreds of residents flock to the Legislature annually decrying their use.
Steve Okoji, supervising sanitarian for the state Department of Health, said his teams ask permission before spraying at homes and work with farmers on possible alternatives. But they have reached only a quarter of households in dengue-affected areas, instead of the recommended 90%, the CDC report said. Okoji said repeated visits have helped improve that number.
Hawaii slashed its mosquito control and entomology staff from 56 employees in 2009 to 25 this year. The state has redirected workers who usually perform sanitation and radiological health roles to help fight dengue.
"We actually have an adequate amount of people and resources to meet this response … but what we're doing is we're just pretty much treading water," Okoji said. "We need to actually try and get ahead of the disease."
The state is advising residents to remove standing water, fix leaky faucets and repair screens to keep mosquitoes out.
Dengue victim BreeLyn DuPertuis, a South Kona massage therapist and organic farmer, allowed crews to spray her property with pesticide.
"I think if there was more resources put toward it, it would have been handled in a more effective way," DuPertuis said. "Of all the times to act, and act aggressively, it's now."
Bussewitz writes for the Associated Press.